Year after year the statistics surrounding running related injuries is staggering. 65-80% of recreational and competitive runner's will miss training time to recover from an injury. That's pretty insane. That means almost everyone who runs gets hurt. What might be more insane is to believe that a blog might contain the secret sauce to overcoming this massive pain in the (knee, ankle, back, hip or foot).You are right to be skeptical because injury prevention is not well documented in the literature. Therefore, amongst huge populations of people, we don't know for certain what will prevent injuries. Here is what we do know and how it can help you to maximize your chances of staying injury free year after year.
Injury Risk Mitigation
This is the term responsible practitioners, coaches, and trainers are using to describe their approach to keeping runners on the road. We are making recommendations about what to wear, how to train, and running technique to encourage runners to stay healthy. Here is a simple plan of how I have success keeping runners pain free.
No not prehab, rehab. The #1 (and only definitive) risk factor for injury is...a previous injury. If you have had achilles tendinitis, patellar tendinitis, IT band syndrome, gluteal strains, low back pain, shoulder, neck or whatever pain, you need a complete and thorough rehab program. Beating back the symptoms until you "feel better" is not rehab. That means manual therapy, dry needling, scraping, KT Tape, massage, adjustments, ice, heat, TENS, ultrasound, laser etc are not rehab. They are modalities aimed at reducing symptoms. Symptoms are indicators that something is wrong. What is wrong is what rehab addresses.
There is no cookie cutter "Patellar Tendinitis Rehab" program available that is reliable because each case is different. Here are the potential causes (or contributing factors) to an injury. Spike in acute workload, unmanageable chronic workload, weakness, shoe wear, biomechanical insufficiencies, unmanaged stress levels, poor sleep, poor nutrition, and more. To list these factors into an algorithm and pump out a level of importance of each intervention would be wonderful, but also impossible. Humans are complex and what we believe contributes to pain and injury is not always the case. Trial and error, expert and athlete experience, and research based evidence all need to combine to determine the best course of action.
The short end of it, if you have had an injury, especially a recurring injury, get it checked out and rehabbed by an expert Performance Physical Therapist before diving into your training. This isn't marketing, this is common sense once you understand the prevalence of re-injury once an injury has occurred.
Let's get some shoes. Every 300-500 miles you need new shoes. The wear that concrete and asphalt running does to your shoes will begin changing the way your foot interacts with the ground. When your foot's contact with the ground becomes less stable on a worn shoe, compensations in the foot, knee and hip begin to develop. Over time this can create unnecessary stress and strain on the muscles, tendons and ligaments. Therefore, old shoes can lead to injury by placing unnecessary strain on the lower leg and hips.
Expanding upon the notion that shoe wear guides our foot's interaction with the ground; heel and forefoot guidance help to fire movement patterns up the chain. If the outside heel on your running shoe is too soft, the heel may be encouraged to roll to far to the outside, even when running with proper form. Likewise, a forefoot that folds up into a pastry roll at the toe lacks sufficient support for many feet. For the vast majority of us, we have spent our lives walking on concrete in supportive shoes. To ditch these, kick on some rubberized socks and hit the hard pavement with higher impact is ludicrous. To find out if a pair of shoes is right for you, seek out a knowledgeable shoe salesman or a qualified Performance Physical Therapist.
Training refers to two things. Running and preparing the muscles, tendons and ligaments of the body for running. Strength training prepares the body to run by increasing the resiliency of your muscles and tendons. By increasing strength, the muscles and tendons are able to tolerate more force. As you run your body absorbs force repeatedly. The longer you run, the more force you absorb. In order to reduce the opportunity for achilles, patellar, and gluteal tendinitis, you need strong muscles and tendons. See the videos posted below for ideas for calf, knee and hip strength training exercises.
Plyometrics should be used to prepare the body to absorb force quickly. Strength training primarily consists of slow tempo movements that recruit a high number of muscle fibers. Plyometrics tend to recruit less fibers but transfer the force from the muscle to the tendons quickly. Being able to appropriately transfer force is important for avoiding heavy impact running patterns. See the videos below for examples of plyometric training exercises for improving your ability to absorb force and transfer it into your body appropriately.
Combined with proper running technique, strength training and plyometrics will substantially decrease your chances of getting injured.
Also under the umbrella of training is periodization of running. AKA when to run how much. These programs are readily available online and are typically in the $10-25 range. Definitely invest in one if you haven't already. If you need a recommendation, shoot me an email at John@HumanFunctionandPerformance.com, I will point you in the right direction.
To summarize, the most sure way to get hurt running isn't running incorrectly. It is something out of your control. It is something that is in the past. A previous injury. The first thing you need to do is ensure your body is not protecting, compensating, or changing your running pattern because of a previous injury. Even when things feel fine, they might not be. They may just be used to the compensations. If you have never had an injury or are certain you have been properly rehabilitated, get a pair of shoes that are appropriate for you, and replace them when you reach the 300-500 mile range. Just as important as having the correct equipment on your feet is preparing the rest of your body to handle the stress of running. Strength training, plyometrics and running gait analysis are vital to reducing your risk of injury and completing your massive fitness goals.